| NPI | 1659895134 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARKITA MARIE THOMPSON Owner 833-422-4673 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MI 4704218652) |
| Enumeration Date | 2017-07-27 |
| Last Update Date | 2022-07-21 |